AHRQ Data Resources to Inform Health Policy Research: The Medical Expe

Slide Presentation from the AHRQ 2011 Annual Conference

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Slide 1

AHRQ Data Resources to Inform Health Policy Research: The Medical Expenditures Panel Survey (MEPS)

AHRQ 2011 Annual Conference

AHRQ Data Resources to Inform Health Policy Research: The Medical Expenditures Panel Survey (MEPS) 

Anita Soni, Ph.D.

Slide 2

MEPS Overview

Medical Expenditure Panel Survey

MEPS Overview

Slide 3

MEPS Overview

MEPS Overview

  • History & Purpose.
  • Survey Components & Design.
  • Sample.
  • Core Content.
  • Supplemental CAPI sections & Questionnaires.
  • Public Use Files.
  • Dissemination of Data.

Slide 4

MEPS History

MEPS History

  • 1977 National Medical Care Expenditure Survey.
  • 1987 National Medical Expenditure Survey.
  • 1996 Medical Expenditure Panel Survey.

Slide 5

MEPS-HC Purpose and Uses

MEPS-HC Purpose & Uses

  • Estimates and tracks annual health care use, expenditures and insurance coverage.
  • Provides estimates of expenditures and sources of payment by selected demographic variables.
  • Used for policy-related and behavioral research on the determinants of health care use, spending, and insurance coverage.
  • Used in microsimulation models to analyze alternative health care delivery proposals.

Slide 6

MEPS Survey Components

MEPS Survey Components

  • MEPS-HC—Household Component.
  • MEPS-MPC—Medical Provider Component.
  • MEPS-IC—Insurance Component.

Slide 7

MEPS-HC Survey Design

MEPS-HC Survey Design

  • Sub-sample of respondents from the previous year's National Health Interview Survey (NHIS).
  • Representative of the civilian non-institutionalized population of the US.
  • Five in-person interviews over 2 1/2 year period using Computer Assisted Personal Interview (CAPI).
  • Interviews average 90 minutes with a range of one to four hours.

Slide 8

Oversampling in MEPS Panels 7-14 (2002-2009)

Oversampling in MEPS Panels 7-15 (2002-2010)

  • Carryover from NHIS:
    • Blacks.
    • Hispanics.
    • Asians (panels 12-15 after 2006 NHIS redesign).
  • Additional MEPS Oversampling:
    • Asians.
    • Low income (panels 7-13).
    • Blacks (panels 9-11, 13-15).
    • Hispanics (panels 13-15).

Slide 9

MEPS Panel Design: Data Reference Periods

MEPS Panel Design: Data Reference Periods

Image of a timeline showing activity of different panels. In 2007 N=29,370; 2008 N=31,262; and 2009 N=34,920.

N is equal to the number of people with a positive person weight on the file.

Slide 10

MEPS-HC Sample Sizes

MEPS-HC Sample Sizes

YearFamiliesPersons
19968,65521,571
199713,08732,636
19989,02322,953
19999,34523,565
20009,51523,839
200112,85232,122
200214,82837,418
200312,86032,681
200413,01832,737
200512,81032,320
200612,81132,577
200711,61529,370
200812,31631,262
200913,87534,920

Slide 11

MEPS-HC Core Interview Content

MEPS-HC: Core Interview Content

  • Demographics.
  • Charges and Payments.
  • Health Status.
  • Conditions.
  • Utilization.
  • Employment.
  • Health Insurance.

Slide 12

MEPS-HC Supplemental CAPI Sections

MEPS- HC Supplemental CAPI Sections

Sections asked in rounds 2 and 4:

  • Access to care.
  • Child preventive health.
  • Satisfaction with health plans & providers.

Sections asked in rounds 3 and 5:

  • Assets (round 5 only).
  • Income.
  • Preventive Care.

Slide 13

MEPS-HC Supplemental Paper Questionnaires

MEPS-HC Supplemental Paper Questionnaires

  • Diabetes Care Survey (DCS):
    • Given once a year to each person identified as having diabetes.
    • Includes questions about diabetes related tests and managing diabetes.
  • Adult Self-Administered Questionnaire (SAQ):
    • Given once a year to each adult 18 years old and older.
    • Focuses on self-reported information such as opinions about health care issues and quality of care measures, assessment of own health, and height /weight.

Slide 14

MEPS-HC Caveats and Limitations

MEPS-HC Caveats and Limitations

  • Sample size limitations preclude some analyses.
  • Typically, one respondent provides data for the entire household.
  • Household respondents may not be able to report accurately certain types of information:
    • Type of health plan.
    • Detailed event information.
    • Diagnoses.

Slide 15

MEPS Conditions Data

Medical Expenditure Panel Survey

Medical Conditions Data

Slide 16

Medical Conditions File

Medical Conditions File

Medical Conditions File contains

  • Household reported data.
  • Data on Conditions.
  • Data on Procedures.

Slide 17

Medical Conditions File Structure

Medical Conditions File Structure

  • Each record represents unique condition or procedure for a person.
  • Persons may be represented on file once, several times or not at all.
  • Can be linked to person and event files for analysis.

Slide 18

MEPS Condition Roster

MEPS Condition Roster

  • One roster per person.
  • Cumulates medical conditions reported across MEPS interviews.
  • Interviewer records verbatim responses to questions in the following 4 sections:
    • Condition Enumeration.
    • Priority Conditions (yes/no).
    • Medical Events.
    • Disability.

Slide 19

Condition Enumeration Question

Condition Enumeration

  • We're interested in learning about health problems that may have bothered (PERSON) {since (START DATE)/between (START DATE) and (END DATE)}:
    • Health problems include physical conditions, accidents, or injuries that affect any part of the body as well as mental or emotional health conditions, such as feeling sad, blue, or anxious about something.

Slide 20

Condition Enumeration Question

Condition Enumeration

  • Asked in every round.
  • Has a time frame (since last interview until today):
    • Responses recorded verbatim and coded into 5 digit ICD9 codes.
    • Responses directly linked to conditions roster.
    • Chronic/priority conditions appear only once on the roaster.
    • Acute conditions can have many records.
    • Responses aggregated across rounds for the annual responses.

Slide 21

 Priority Conditions

Priority Conditions

  • New section since Panel 12.
  • Separate section of questionnaire.
  • Series of questions asking if "ever" had condition:
    • "Yes/no" responses, no ICD9 coding.
    • Responses of yes with a current utilization record will appear on person's condition roster.
  • Factors used in determining priority conditions:
    • Prevalence.
    • Expenditures.
    • Policy relevance.

Slide 22

 Priority Conditions List


Priority Conditions List

  • Heart disease.
  • Heart attack.
  • Angina.
  • High cholesterol.
  • Cancer.
  • Stroke.
  • High blood pressure.
  • Diabetes.
  • Asthma.
  • Arthritis/Joint pain.
  • Emphysema.
  • Chronic bronchitis.
  • Attention deficit disorder.

Slide 23

 Medical Events

Medical Events

  • What conditions were discovered or led (Person) to make this visit? Probe: Any other condition? If Condition is Already Listed, Ask: Is this the same (Name of Condition) that we have already talked about before?
    • Types of visits:
      • Inpatient.
      • Outpatient.
      • Emergency Room.
      • Office Based.
      • Home Health.
  • Conditions associated with Prescribed Medicine purchases:
    • What health problem is (Medicine) prescribed for? Probe: Any other health problems?

Slide 24

 Event Count Variables

Event Count Variables

  • Indicates number of events associated with condition for person:
    • Home Health (HHNUM).
    • Inpatient stays (IPNUM).
    • Hospital outpatient (OPNUM).
    • Office-based (OBNUM).
    • Emergency room (ERNUM).
    • Prescription Medicine purchases (RXNUM).

Slide 25

 Disability Days Condition Questions

Disability Days Condition Questions

  • Missed school or work:
    • What are the health problems that caused (PERSON) to miss work/school on those days? PROBE: Any other health problems?
  • Bed days:
    • What are the health problems that caused (PERSON) to spend half day or more in bed on those days? PROBE: Any other health problems?

Slide 26

Reporting and Recording Conditions  

Reporting and Recording Conditions

  • Respondents may report having the same condition more than once:
    • Interviewer probes whether occurrence of condition already reported.
    • Each unique episode of a condition recorded only once:
      • Person may have multiple colds in year.
      • Each cold has separate record.

Slide 27

 Reporting and Recording Conditions

Reporting and Recording Conditions

  • Respondents may report having the same condition more than once:
    • Interviewer verifies that these are different occurrences of the condition.
    • Each unique episode of a condition is recorded only once:
      • Person may have more than one cold in a year.
      • Each cold has a separate record.

Slide 28

 Accidents and Injury Questions

Accidents and Injury Questions

  • Following items asked if relevant to reported condition:
    • Date of accident.
    • Place (work, home, school, etc.).
    • Cause (gun, vehicle, fall, fire, etc.).
    • Whether or not the person has recovered from the injury.

Slide 29

 Condition Coding and Editing

Condition Coding and Editing

  • Fully specified ICD-9 CM codes (up to 5 digits).
  • ICD-9 condition codes collapsed to 3 digits to maintain confidentiality.
  • Approximately 10% of condition codes are collapsed further by combining 2 or more 3-digit codes.

Slide 30

 Procedure Coding and Editing

Procedure Coding and Editing

  • Only obtained from Medical Events Questions.
  • Fully specified ICD-9 CM codes (up to 4 digits):
    • Collapsed to 2-digit codes.
    • Approximately 3% collapsed further by combining 2 or more 2-digit codes.

Slide 31

 Clinical Classification Codes (CCC)

Clinical Classification Codes (CCC)

  • ICD-9 codes aggregated into broad clinically meaningful categories.
  • Edited to preserve confidentiality.
  • Crosswalk included in documentation.
  • Formerly Clinical Classification for Health Policy Research (CCHPR).

Slide 32

 Condition-Event Link Files

Condition-Event Link Files

  • Used to link conditions to:
    • Persons on person files:
      • All reported conditions or just those associated with events.
    • Events on event files:
      • Most conditions associated with events already included on event files.
  • Separate link file for prescribed medicines.

Slide 33

 National Estimates of Conditions

National Estimates of Conditions

  • Most appropriate to estimate "treated prevalence"
    • MEPS Web site summary data tables on Expenditures by Medical Condition.
  • Condition more likely to be underreported if:
    • Respondent/person not aware.
    • Not salient or bothersome.
    • No medical care received.

Slide 34

 Condition Data Limitations/Caveats

Condition Data Limitations/Caveats

  • Household-reported:
    • One respondent usually providing information for all household members.
  • Many recorded text strings not easily classifiable into ICD-9 codes.
  • Limited information on procedures.
  • Not suitable for prevalence estimates.
  • More salient conditions tend to be better reported.

Slide 35

Health Care Utilization And Expenditures Data  

Medical Expenditure Panel Survey

Health Care Utilization and Expenditures

Slide 36

 Health Care Utilization

Health Care Utilization

  • MEPS household respondents asked to report all health care use for family members during reference period.
  • Utilization is called an "event" in MEPS.
  • Event type categories:
    • Office-Based Medical Provider Visits (OB).
    • Hospital Inpatient Stays (IP).
    • Outpatient Department Visits (OP).
    • Emergency Room Visits (ER).
    • Dental Visits (DN).
    • Prescription Medicine Purchases (RX).
    • Home Health Care (HH).
    • Other Medical Expenses (OM).

Slide 37

 Health Care Expenditures

Health Care Expenditures

  • Collected at the event level.
  • Represent payments to providers of the health care.
  • Payments are reported by source (e.g., out-of-pocket, private insurance, public program).
  • Total expenditure is sum of payments across all sources of payment.

Slide 38

Source of Payment Categories in CAPI  

Source of Payment Categories

  • Self or family.
  • Medicare.
  • Medicaid/SCHIP.
  • Private insurance.
  • VA.
  • TRICARE.
  • Other federal government.
  • State or local government.
  • Worker's comp.
  • Other insurance.

Slide 39

Sources of Expenditure Data  

Sources of Expenditure Data

  • Expenditures derived from two survey components:
    • Medical Provider Component (MPC).
    • Household Component (HC).
  • MPC data used when available.
  • HC data used when no MPC data available.
  • Events with no MPC or HC data on expenditures are imputed:
    • Results in no missing values.

Slide 40

 Sources of Expenditure Data By Event Type

Sources of Expenditure Data by Event Type

Event typeHCMPC
OB: Physicianyesyes
OB: Non-Physicianyesno
IP/OP/ER (hospital events)yesyes
DNyesno
RXno*yes
HH: Agencynoyes
HH: Paid independentyesno
OMyesno

*Except for self-filers.

Slide 41

 Annual Utilization and Expenditure Data

Annual Utilization and Expenditure Data

  • Annual data cumulated across approximately 2 1/2 rounds of data collection.
  • Event level files:
    • Separate by type of service.
    • Unique record for each reported event:
      • Some persons have no events.
      • Some persons have multiple events.
  • Person-level file (full year consolidated):
    • Variables derived from event level.

Slide 42

 Event Level File Record Units

Event Level File Record Units

Event TypeRecord Unit
OBvisit
OPvisit
ERvisit
IPstay
DNvisit
HHmonth
RXoriginal script or refill

Slide 43

Event File Expenditure Variables: OB, DN and OM

Event File Expenditure Variables: OB, DN and OM

  • 12 expenditure by source of payment variables.
  • A total expenditure variable:
    • Sum of 12 source of payment variables.
  • A total charge variable:
    • Provider's charge before adjustment or discount.

Slide 44

Hospital Event Files Expenditure Variables: IP, OP, and ER

Hospital Event Files Expenditure Variables: IP, OP, and ER

  • Facility Expenditure Variables:
    • 12 expenditure by source of payment variables.
    • A total facility expenditure variable.
    • A total facility charge variable.
  • Separately Billing Doctor Expenditure (SBD) Variables:
    • 12 SBD expenditure by source of payment variables.
    • A total SBD expenditure variable.
    • A total SBD charge variable.
  • Total Expenditures for the event:
    • Sum of facility and SBD expenditures.
  • Total charges for the event:
    • Sum of facility and SBD charges.

Slide 45

Common Variables in Event Files

Common Variables in Event Files

  • Person/event ID.
  • Date(s) of care (not RX).
  • Services/procedures.
  • Type of provider (not RX,ER,IP).
  • Expenditure variables.
  • Full year person weight.
  • Variance estimation variables.
  • Imputation flag.

Slide 46

Event Files: Medical Conditions

Event Files: Medical Conditions

  • IP:
    • Up to 4 per event.
  • OB, OP, ER & RX:
    • Up to 3 per event.
  • HH:
    • Need to obtain from condition file.
  • DN & OME:
    • No medical conditions.

Slide 47

IP variables

IP variables

  • Have operation?
  • Stay begin with ER visit?
  • Number of nights in hospital.
  • Reason for stay (5 broad reasons).
  • Stay related to specific condition (yes or no); if yes, provide condition(s).
  • VA facility?

Slide 48

Diagnostic Tests/Services Received During OB, OP, or ER Visit

Diagnostic Tests/Services Received During OB, OP, or ER Visit

  • Laboratory tests.
  • Sonogram/ Ultrasound.
  • X-ray.
  • Mammogram.
  • MRI/CAT SCAN.
  • EKG/ECG.
  • EEG.
  • Vaccination.
  • Surgery.
  • Anesthesia.
  • Other tests or exams.

Slide 49

Main Medical Provider OB and OP Visits

Main Medical Provider: OB and OP Visits

  • Specialty if a physician:
    • 33 specialties plus "other"
  • Type of provider if not a physician:
    • 17 types plus "other"

Slide 50

Treatments During an OB or OP Visit

Treatments During an OB or OP Visit

  • Physical therapy.
  • Occupational therapy.
  • Speech therapy.
  • Chemotherapy.
  • Radiation therapy.
  • Kidney dialysis.
  • IV therapy.
  • Treatment for drug or alcohol.
  • Received allergy shot.
  • Psychotherapy or counseling.

Slide 51

Category of Care Received During an OB or OP Visit

Category of Care Received During an OB or OP Visit

  • General checkup.
  • Diagnosis or treatment.
  • Emergency.
  • Well child exam.
  • Follow-up or post-op visit.
  • Psychotherapy or mental health counseling.
  • Maternity care.
  • Immunizations or shots.
  • Laser eye surgery.

Slide 52

Prescribed Medicines (PMED) Event File

Prescribed Medicines (PMED) Event File

  • Each record represents an original RX script or refill:
    • Includes diabetic supply/equipment and insulin purchases.
    • Contains drug characteristic and expenditure variables.

Slide 53

PMED File Expenditure Variables

PMED File Expenditure Variables

  • Source:
    • Nearly all MPC (pharmacy) data.
    • Some source of payment information collected from households filing their own insurance claims.
  • Variables:
    • 12 expenditure by source of payment.
    • Total expenditure variable.
    • No total charge variable.

Slide 54

Variables in the PMED File

Variables in the PMED File

  • Household Component (HC) variables collected in each round:
    • Medicine name.
    • Number of times purchased.
    • Used to treat a condition.
    • Date first used.
    • Pharmacy information.
    • Names of free samples.
    • Who files prescribed drug insurance claims.

Slide 55

Drug characteristics

Drug characteristics

  • Drug characteristics included for each prescribed medicine event:
    • Medication name.
    • National drug code (NDC).
    • Quantity dispensed (e.g., 50).
    • Form (e.g., suspension).
    • Strength (e.g., 10).
    • Unit of measurement of form (e.g., cc) and strength (e.g., mg).
    • Brand/generic designation (from Multum Lexicon).
    • Therapeutic class, sub-class, and sub sub-class (from Multum Lexicon).
    • Pregnancy category (from Multum Lexicon).

Slide 56

Home Health (HH) Event File

Home Health (HH) Event File

  • Three broad categories:
    • Agency care (including hospitals and nursing homes).
    • Paid independent providers.
    • Informal providers (e.g., family and friends).
  • Each record in file represents monthly aggregate for specific type of care.

Slide 57

HH File Expenditure Variables

HH File Expenditure Variables

  • Agency care:
    • 12 expenditure by source of payment variables.
    • A total expenditure variable.
    • A total charge variable.
  • Paid independent providers:
    • Same expenditure variables as Agency care.
  • Informal care:
    • No expenditure variables.

Slide 58

Home Health Variables

Home Health Variables

  • Type of worker(s) provided:
    • Agency care only.
  • Type of care.
  • Amount of care:
    • (frequency and length of visits).

Slide 59

Dental Event File Type of Provider Seen

Dental Event File Type of Provider Seen

  • General dentist
  • Dental Hygienist
  • Dental Technician
  • Dental Surgeon
  • Orthodontist
  • Endodontist
  • Periodontist
  • Other

Slide 60

Dental Services and Procedures

Dental Services and Procedures

  • Diagnostic or preventative.
  • Restorative or endodontic.
  • Periodontic (gum treatment).
  • Oral surgery.
  • Prosthetics.
  • Orthodontics.
  • Other procedures.

Slide 61

Other Medical Expenditures File

Other Medical Expenditures File

Type (OMTYPEX)Record Unit
Glasses or contactsround
Ambulance servicesannual
Orthopedic itemsannual
Hearing devicesannual
Prosthesisannual
Bathroom aidsannual
Medical equipmentannual
Disposable suppliesannual
Alterations/modificationsannual
Otherannual

Slide 62

Flat Fees

Flat Fees

  • What is a Flat Fee?
    • Fixed dollar amount paid for a group of health care services.
    • Common examples: orthodontic, prenatal care.
  • Flat Fee ID: FFEEIDX.
  • Flat fee structure (FFevTYPE):
    • Stem—Initial medical visit—expenditures.
    • Leaf—subsequent medical visits—zero expenditures

Slide 63

Zero Dollar Events

Zero Dollar Events

  • Reasons for $0 total expenditures:
    • Flat fee leaf event from prior year.
    • Follow-up visit without extra charge.
    • Free care.
    • Bad debt.

Slide 64

Annual Person-Level File with Expenditure Data

Annual Person-Level File with Expenditure Data

  • Full Year Consolidated File:
    • One record for each person in MEPS.
    • Summary of all events and expenditures:
      • Appendix 1 of documentation contains naming conventions for use and expenditure variables.
    • No detail on expenditures or characteristics of individual events.

Slide 65

Health Insurance Data

Medical Expenditure Panel Survey

Health Insurance Data

Slide 66

Health Insurance Public Use Files, 2008-2010

Health Insurance Public Use Files, 2008-2010

  • MEPS HC-125 :
    2010 P14R3/P15R1, Point-in-Time Population Characteristics.
  • MEPS HC-123:
    2009 Full Year Population Characteristics Data File.
  • MEPS HC-119:
    2008 Person Round Plan Public Use File.

Slide 67

2010 Point-in-Time Public Health Insurance Variables

2010 Point-in-Time Public Health Insurance Variables

  • TRINW31X COV by TRICARE at Interview—Edited.
  • MCARE31X COV by MEDICARE—Edited.
  • MCAID31X COV by MEDICAID—Edited.
  • OTPUBA31 COV by/Pays OTH Gov MCAID HMO.
  • OTPUBB31 COV by OTH Public Not MCAID HMO.
  • STPRG31 COV by State Specific Program.
  • PUB31X COV by Public INS—Edited.

Slide 68

2010 Point-in-Time Private Health Insurance Variables

2010 Point-in-Time Private Health Insurance Variables

  • PRIEU31 COV by PRIV EMPL/UNION Plan.
  • PRIDK31 COV by PRIV DK Plan.
  • PRING31 COV by Nongroup Plan.
  • PRIOG31 COV by OTH GROUP Plan.
  • PRIS31 COV by SELF-EMP-1 INS.
  • PRIOUT31 COV by Holder Outside RU.
  • PRIV31 COV by Private INS.
  • INSRD31X Insured—Edited.

Slide 69

2010 Point-in-Time Policy Holder Insurance Variables

2010 Point-in-Time Policy Holder Insurance Variables

  • HPRIEU31 Holder of PRIV EMPL/UNION Plan.
  • HPRIDK31 Holder of PRIV DK Plan.
  • HPRING31 Holder of NONGROUP Plan.
  • HPRIOG31 Holder of OTH GROUP Plan.
  • HPRIS31 Holder of SELF-EMP-1 INS.
  • HPRIV31 Holder of PRIV INS Plan.

Slide 70

2009 Full Year Population Characteristics Data File Public Insurance

2009 Full Year Population Characteristics Data File: Public Insurance

Month by month indicators

  • TRIJA09X-TRIDE09X—TRICARE.
  • MCRJA09X-MCRDE09X—Medicare.
  • MCDJA09X-MCDDE09X—Medicaid/SCHIP.
  • OPAJA09-OPADE09—managed care, other public insurance.
  • OPBJA09-OPBDE09—not managed care, other public insurance.
  • STAJA09-STADE09—state-specific program participation.
  • PUBJA09X-PUBDE09X—indicates public insurance in month.

Slide 71

2009 Full Year Population Characteristics Data File Private Insurance

2009 Full Year Population Characteristics Data File: Private Insurance

Month by month indicators:

  • PEGJA09-PEGDE09— employer/union group insurance.
  • PNGJA09-PNGDE09—non-group private insurance.
  • POGJA09-POGDE09—other group private insurance.
  • PDKJA09-PDKDE09— don't know source of insurance.
  • POUJA09-POUDE09—policy holder is outside the household.
  • PRSJA09-PRSDE09—self-employed with firm size of 1.
  • PRIJA09-PRIDE09— indicates private insurance in month.
  • Policy Holders (repeat of Private) "H".

Slide 72

2009 Full Year Population Characteristics Data File Summary Variables

2009 Full Year Population Characteristics Data File: Summary Variables

Month by month indicators:

  • PUBJA09X-PUBDE09X—indicates public insurance in month.
  • PRIJA09-PRIDE09—indicates private insurance in month.
  • INSJA09X-INSDE09X—indicates any insurance in month.

Slide 73

2009 Full Year Population Characteristics Data File Summary Variables (continued)

2009 Full Year Population Characteristics Data File: Summary Variables (continued)

  • UNINS09—uninsured all of 09.
  • INSCOV09—health insurance indicator 09:
    • 1 = Any Private during 2009.
    • 2 = Public Only during 2009.
    • 3 = Uninsured all of 2009.

Slide 74

2009 Full Year Population Characteristics Data File Managed Care

2009 Full Year Population Characteristics Data File: Managed Care

Public insurance.

  • Medicare Managed Care Plan.
  • Medicaid or SCHIP HMO.
  • Medicaid/SCHIP Gatekeeper Plans.

Slide 75

2009 Full Year Population Characteristics Data File Managed Care

2009 Full Year Population Characteristics Data File: Managed Care

Private insurance:

  • Private HMOs.
  • Private HMO Plans that Pay for Visits to Non-Plan Doctors.
  • Private Gatekeeper Plans.
  • Private Gatekeeper Plans that Pay for Visits to Non-Plan Doctors.
  • Private Plan that has a Book or List of Doctors.
  • Private Plan that has a Book or List of Doctors that Pays for Non-Plan Visits.

Slide 76

2009 Full Year Population Characteristics Data File Ever Covered During the Year

2009 Full Year Population Characteristics Data File: Ever Covered During the Year

  • TRIEV09— by TRICARE.
  • MCREV09—by Medicare.
  • MCDEV09—by Medicaid.
  • OPAEV09—managed care, other public insurance .
  • OPBEV09—not managed care, other public insurance.
  • PRVEV09—by private health insurance.

Slide 77

2009 Full Year Population Characteristics Data File Medicare Part D

2009 Full Year Population Characteristics Data File: Medicare Part D

  • MCRPD31X:
    • Medicare prescription drug benefit (Part D), Rounds 3 and 1.
  • MCRPD42X:
    • Medicare prescription drug benefit (Part D), Rounds 4 and 2.
  • MCRPD09X:
    • Medicare prescription drug benefit (Part D), end of year.

Slide 78

2009 Full Year Population Characteristics Data File

2009 Full Year Population Characteristics Data File

  • DENTIN31/42/53—round specific variables:
    • Covered by a private health insurance plan that included at least some dental coverage.
  • PMEDIN31/42/53—round specific variables:
    • Covered by a private health insurance plan that included at least some prescribed medicine coverage.

Slide 79

Person Round Plan Public Use File (PRPL)

Person Round Plan Public Use File (PRPL)

  • Reflects complex and dynamic relationships between people and their private insurance.
  • Contains records for persons with:
    • Hospital/physician coverage.
    • Medigap.
    • Dental, vision, or prescription medication coverage.
  • Contains variables pertaining to managed care and satisfaction with plan.
  • Out-of-pocket premiums (starting in 2001).

Slide 80

MEPS-IC Survey (Insurance Component)

MEPS-IC (Insurance Component)

  • Collects data from private and public sector employers on the health insurance plans they offer their employees.
  • Contains information on types of private insurance plans offered, premiums, contributions by employers and employees, eligibility requirements and cost information.
  • Funded by the Agency for Healthcare Research and Quality (AHRQ).
  • Conducted by the U.S. Census Bureau.

Slide 81

MEPS-IC Survey

MEPS-IC Sample

  • Nationwide, private and public sector establishments.
  • The sample contains about 40,000 establishments and supports national and state-level estimates for all 50 states.
  • Survey data available for 1996 through 2009 (not 2007).

Slide 82

MEPS-IC Sample Design

MEPS-IC Sample Design

  • Private establishments from the Census Bureau's Business Register:
    • Approximately 42,000 establishments sampled.
  • State and local governments from the Census of Governments:
    • Approximately 2,500 governmental units sampled.

Slide 83

Types of Information Collected

Types Of Information Collected

  • Establishment-level (location) characteristics.
  • Health insurance plan characteristics.
  • Firm-level (company) characteristics.

Slide 84

Establishment-level (Location) Characteristics

Establishment-level (Location) Characteristics

  • Number of active employees.
  • Whether or not establishment offers health insurance.
  • Number of plans offered.
  • Number of employees eligible for health insurance and number enrolled (full-time and part-time employees separately).
  • Workforce characteristics.

Slide 85

Health Insurance Plan Characteristics

Health Insurance Plan Characteristics

  • Premiums (single, employee-plus-one, family).
  • Contributions.
  • Plan types (by type of provider arrangement).
  • Self-Insured / Fully-Insured.
  • Enrollments (single, employee-plus-one, family coverage).
  • Deductibles / Co-payments.

Slide 86

Firm (Company) Characteristics

Firm (Company) Characteristics

  • Size.
  • Industry.
  • Age of firm.
  • Retiree offerings.
  • Employee characteristics.

Slide 87

MEPS-IC Data

MEPS-IC Data

  • Annual estimates:
    • National.
    • State.
    • Some Metro areas.
  • Data Census Bureau Confidential—Public Use Files not available.
  • Methodology Reports available on MEPS Web site.

Slide 88

MEPS Public Use Files

MEPS Public Use Files

Slide 89

MEPS Public Use Files

MEPS Public Use Files

  • MEPS-HC: Most files are on the Web site and are called Public Use files. These files can be downloaded from MEPS Web site.
  • MEPS-IC: No data files are available. The data is posted on the MEPS Web site in the tabular form.
  • MEPS-MPC: Data is used to impute the data collected in MEPS-HC, no separate MPC files are available for public use.

Slide 90

 Levels of MEPS-HC Public Use Files

Levels of MEPS-HC Public Use Files

  • Person Level—detailed person information.
  • Event Level—detailed event information.
  • Condition Level—detailed condition information.
  • Job Level—detailed job information.

Slide 91

 Types of MEPS-HC Files

Types of MEPS-HC Files

  • Full-year Files – Contain expenditure and utilization data for the calendar year from several rounds of data collection:
    • Full Year Consolidated Data File.
    • Event File.
    • Medical Conditions File.
    • Jobs File.
    • Person Round Plan Public Use File.
  • Point-in-time Files – Data for the beginning of the year providing early glimpses of what full-year estimates will likely be.
  • MEPS/NHIS Link Files – Cross-walk files that allow merging of Household Component files and NHIS files.

Slide 92

Details on MEPS PUFs  

Details on MEPS PUFs

  • Documentation Files:
    • Contain general information about MEPS.
    • Contain survey information specific to each file.
    • Contain variable-source crosswalk to link back to questionnaire items.
  • File Codebooks:
    • Contains names and location of all variables.
    • List both weighted and unweighted estimates.

Data files and related documentation are available for downloading on MEPS Web site: http://meps.ahrq.gov/mepsweb.

Slide 93

 Dissemination of Information and Data Products

Medical Expenditure Panel Survey

Dissemination of Information and Data Products

Slide 94

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Slide 95

 MEPS Web Site

MEPS Web site

  • Materials on the MEPS Web site:
    • Questionnaires:
      • Core and Supplemental.
    • Summary data tables
      • Expenditures by Health Care Service.
      • Expenditures by Medical Condition.
      • Health Insurance.
      • Quality of Care.
      • Prescription Drugs.
      • State-Level Medical Expenditures.
      • Access to Care.
    • Interactive MEPS query tool – MEPSnet.
    • Publications
      • Statistical Briefs.
      • Methodology Reports.
      • Research Findings.

Slide 96

Data User Workshops  

Data User Workshops

  • Information will be posted on Workshops and Events section of Web site.
  • For inquiries please e-mail: Workshopinfo@ahrq.hhs.gov.

Slide 97

 MEPS Publications

MEPS Publications

  • Statistical Briefs: Easy-to-read, concise graphical summaries of MEPS data.
  • Research Findings and Highlights: Tables and summaries of descriptive statistics.
  • Methodology Reports: Detailed information on MEPS sample design and survey methods.
  • Chartbooks: Policy-sensitive topics in an accessible question-and-answer format.
  • Working Papers: Preliminary analyses of methodological and technical issues by AHRQ staff.
  • Research in Action: Analyses using research results from AHRQ-sponsored studies, including MEPS data.

Slide 98

 AHRQ Data Center (ADC)

AHRQ Data Center (ADC)

  • Provides researchers access to non-public use MEPS data (except directly identifiable information).
  • Location of data analysis:
    • On secure LAN at AHRQ.
    • Census Remote Data Center (RDC).

Slide 99

 ADC Application And Procedures

ADC Application And Procedures

  • Submit proposal to Data Center coordinator.
  • Review within 2 weeks for feasibility, and data availability.
  • Institutional Review Board (IRB) review required.
  • Application procedures in detail are on the MEPS Web site.

Slide 100

 ADC Fees

ADC Fees

  • User fee of $300 for approved projects to cover technical assistance, simple file construction, and/or up to 4 hours of programming support from data contractor.
  • User fee waived for full-time graduate students working on dissertations or other degree requirements, and Federal Government agencies.
  • Fee is also waived if you use any of the Census Bureau's Remote Data Centers (RDC); if there are any additional fees required by the Census Bureau, user is responsible for those fees.

Slide 101

 ADC Guidelines

ADC Guidelines

  • Researcher may bring data in, but not out.
  • Researcher has access only to data needed for approved project.
  • All tabular data will be reviewed for confidentiality before release from Center.
  • Only approved tables can leave the Center.
  • Center will store data files, foreign merge files, and all outputs needed for replication.

Slide 102

 MEPS Web Analytical Tools

MEPS Web Analytical Tools

The MEPS Web site contains two web analytical tools:

  • MEPSnet Query Tools.
  • Customizable Summary Data Tables.

Slide 103

 MEPSnet Query Tools

MEPSnet Query Tools

MEPSnet is a collection of analytical tools offering online capability to generate MEPS estimates. The tools are divided into two sections:

  • MEPSnet/Household Component MEPSnet/HC.
  • MEPSnet/Insurance Component MEPSnet/IC.

Slide 104

 Customizable Summary Data Tables

Customizable Summary Data Tables

The following MEPS Summary Data Tables are customizable:

  • All of the Expenditures by Health Care Service Tables.
  • All of the Expenditures by Medical Condition Tables.
  • All of the Quality of Care Tables.
  • Only Table 1, Usual Source of Health Care and Selected Population Characteristics, United States from the Access to Care Tables.

Slide 105

More MEPS Questions?  

More MEPS Questions?

E-mail: anita.soni@ahrq.hhs.gov

Page last reviewed March 2012
Internet Citation: AHRQ Data Resources to Inform Health Policy Research: The Medical Expe: Slide Presentation from the AHRQ 2011 Annual Conference. March 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/events/conference/2011/soni/index.html